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Left ventricular aneurysm. The Wessex experience
Insights
Surgical repair of left ventricular aneurysms can be performed with low operative mortality. This procedure offers good long-term survival and improved quality of life for patients with left ventricular aneurysm.
Area of Science:
- Cardiovascular Surgery
- Cardiac Surgery
- Aneurysm Repair
Background:
- Left ventricular aneurysms are a serious complication of myocardial infarction.
- Indications for surgery include heart failure, angina, and arrhythmias.
Purpose of the Study:
- To evaluate the outcomes of surgical intervention for left ventricular aneurysms.
- To assess the early mortality, long-term survival, and functional status after surgery.
Main Methods:
- A retrospective analysis of 100 patients who underwent surgery for left ventricular aneurysms between 1973 and 1983.
- Procedures included aneurysmectomy, plication, mitral valve replacement, and coronary artery bypass grafting.
- Patient data included indications for surgery, infarct location, and perioperative outcomes.
Main Results:
- The early mortality rate was 7%, with no deaths since 1978.
- Actuarial five-year survival was 68%.
- 82% of survivors were in New York Heart Association class I or II after a mean follow-up of three years.
Conclusions:
- Left ventricular aneurysmectomy can be performed with acceptable operative risk.
- Surgical treatment yields favorable long-term survival and functional outcomes.
Abstract:
One hundred patients with left ventricular aneurysms were operated on between February 1973 and January 1983. The principal indications for operation were left ventricular failure in 58, angina in 23, both in 17, with arrhythmia and systemic emboli accounting for one case each. Eighty five had had anterior infarction causing 82 anteroapical and three lateral aneurysms, while the remainder had had inferior infarcts resulting in 14 inferior aneurysms and one lateral aneurysm. Coronary angiography detected a single coronary lesion in 46%. Three patients had aneurysmal plication and the remainder had aneurysmectomy. Eleven mitral valve replacements were performed. Forty patients underwent coronary artery bypass grafting with a mean number of grafts per patients of 1.4. The early mortality was 7% with no early deaths since 1978. The actuarial five year survival was 68%, and 82% of survivors are in New York Heart Association class I or II (mean follow up three years). Left ventricular aneurysmectomy may be performed with a low operative mortality and good long term results.